Body clock could be key to better Asthma treatment

The human body clock could have a significant impact on the way doctors are able to diagnose and treat asthma, according to new research.

Study leader Dr Hannah Durrington from The University of Manchester says the work has important implications on clinical practice in asthma and other inflammatory conditions.

The study of over 300 severe asthmatics found their sputum samples were more than twice as likely to have more inflammatory cells - or eosinophils - in morning clinics than in the afternoon.

Levels of eosinophils - a biomarker in sputum - are used to guide treatment in severe asthma patients.

The study was funded by Asthma UK, the JP Moulton Charitable Trust, the North West Lung Charity and also the NIHR Manchester Biomedical Research Centre.

It is published in the American Journal of Respiratory and Critical Care Medicine.

Doctor and patients have long known that asthma symptoms are at their worst in the small hours of the morning.

But previous research has shown that the worsening symptoms are biological in cause, rather than a result of lying down.

Dr Samantha Walker, Director of Research and Policy at Asthma UK said: “This is an exciting preliminary study that reveals how powerful the body clock can be. If doctors and nurses know that the time of day can affect someone’s asthma they will be able to diagnose and treat them more effectively.

“Around 5.4million people in the UK have asthma and it can have a huge impact on their life, leaving them gasping for breath and at risk of a potentially fatal asthma attack. But asthma is a chronic condition with complex causes and triggers that can differ from patient to patient. More research into better ways of diagnosing asthma is urgently needed to develop better tests and to help develop more targeted treatments. For more information on how Asthma UK is supporting research and to get involved visit asthma.org.uk/research.”

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These research results are really exciting but at an early stage – our aim was to understand a bit more about how the body clock affects the biochemistry of a person with asthma. But we are pleased because our work should help with the accurate diagnosis and treatment of asthma in the future. We feel it may also have important implications on other lung conditions, as well as outside respiratory medicine.

Dr Durrington said: “These research results are really exciting but at an early stage – our aim was to understand a bit more about how the body clock affects the biochemistry of a person with asthma.

“But we are pleased because our work should help with the accurate diagnosis and treatment of asthma in the future.

“We feel it may also have important implications on other lung conditions, as well as outside respiratory medicine.

“Based on our results, different clinical decisions could be made depending on whether the patient is allocated a morning or afternoon appointment.

“And it also points towards opportunities for more personalised treatment for asthma care in the future.

“In the same way that measuring glucose levels in diabetes allows adjustment of insulin dosing, we may see asthmatics monitoring their biomarker chemicals during the day, to help inform optimum treatment times.”

The University of Manchester is home to the largest biological timing research community in Europe. Dr Durrington also provides an asthma clinic at Wythenshawe Hospital, Manchester University NHS Foundation Trust (MFT).